Pharmacology Day 1
description
Transcript of Pharmacology Day 1
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Pharmacology Day 1
Elizabeth Keele, RN/BSN
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Course Objective #2
• Describe the dynamic process between the giver and the receiver of medications, which promotes positive medication compliance.
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“Dynamic Process”
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• dy·nam·ic• dīˈnamik/• adjective• 1. ( process or system) characterized by
constant change, activity, or progress.
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“Dynamic Process”
• Giver • Receiver
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“Mutual process”
• Key characteristics:–Knowledge– Teaching–Communication–Observation skills– Evaluation skills
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Turn to your neighbor and take turns…
• Describing the dynamic process between the giver and the receiver of medications, which promotes positive medication compliance. • (Course objective #2)
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Course Objective #1
• Identify limitations/deficits commonly seen in D.D. clients that prevent them from asking questions or reporting adverse effects regarding medications they receive.
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Limitations to “mutual process” of medication administration
• Understanding• Communication• Awareness
• Knowledge• Teaching• Communication• Observation• Evaluation
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Limitations to “mutual process” of medication administration
• The NURSE must “account and compensate” for these limitations
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Medication Administration is…
• Invasive• Risk to benefit
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Turn to your neighbor and take turns
• Identify limitations/deficits commonly seen in D.D. clients that prevent them from asking questions or reporting adverse effects regarding medications they receive.
• (Course objective #1)
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Course Objective #3
• Describe the importance of patient teaching with regard to prescribed medication regimen.
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Why is patient teaching important?
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Teaching / Learning Process
• Teaching– Interactive process
• Learning– Acquiring new
knowledge• Motivation– Desire
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3 Domains of Learning
• Cognitive– Intellectual activities
• Affective–Attitudes & beliefs
• Psychomotor–Physical skills
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Turn to your neighbor and…
• Describe the importance of patient teaching with regard to prescribed medication regimen.
• (Course objective #3)
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Course Objective #4
• Describe the electrochemical processes of the central nervous system, which allow CNS drugs to cause their desired effects.
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Course objective #12
• Explain how chemicals and electrical impulses interact to make up the electrochemical properties of the nervous system.
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The nervous system consists of:
• Divided system– Central Nervous System (CNS)• Brain & Spinal Cord
– Peripheral Nervous System (PNS)• Nerves (peripheral & Cranial)
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Nervous System
• Controls and coordinates the body
• By transmission of electrical impulses (Electrical-chemical system)
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Nerve Impulse
• The nervous system is powered by electrical and chemical energy– K+– Na+– Cl-– (Ca+)
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Course objective #9
• Differentiate between afferent and efferent neuron.
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Neuron
• Basic functional unit– Afferent neuron
• Sensory• Carry info from PNS CNS
– Efferent neuron• Motor• Carry into from CNS PNS
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Neuron structure
• Cell body/ Soma– Nucleus– Neurotransmitters synthesized
• Dendrites– Carry impulses toward the cell
body• Axons
– Carry impulses away from the cell body
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Cool Fact Damaged Neuron
• CNS = – Irreversible
• PNS = –will repair itself if
the cell body is not destroyed
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Course Objective #10
• Describe the role played by neurotransmitters in nerve impulse transmission within the synapse.
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Synaptic Junction
• Neuron connect to each other end to end
• Where two neurons come together– Synaptic junction– Synapse– Inter-neuron space
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Anatomy of the NS
• Synapse = the space between one neuron & the next
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Pre-synaptic neuron
Post-synaptic neuron
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Synaptic Junction
• Terminal end of Axon = Pre-Synaptic Vesicles
• Nerve impulse reaches the vesicle release substance neurotransmitters (nt) into the synaptic junction
• Nerve impulses must have a receptor site
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Synaptic events
• Electrochemical message received• Vesicle opens• NT are released into synapse• NT finds its receptor site that it fits into on the next
neuron• Activation of receptor nerve impulse in post-
synaptic vessel • Re-uptake of NT
– MAO action
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Neurotransmitters
• Synthesized in the soma • Special Properties
– Excitability – Inhibitory
• 30+ neurotransmitters
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Course objective #11
• Describe the role played by monoamine oxidase in nerve impulse transmission within the synapse.
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Monoamine oxidase (MAO)
• ENZYME • Released into the synaptic space• Action–breakdown or inactivates NT
• Result–i NT levels
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Course Objective #5
• Differentiate between the following neurotransmitters:– Acetylcholine– Norepinephrine– Dopamine– Serotonin– Gamma-aminobutyric acid– Glycine
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Neurotransmitters
• Synthesized in the soma • Special Properties
– Excitability – Inhibitory
• 30+ neurotransmitters
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Excitatory Neurotransmitters
• Serotonin– Sleep– Sensory perception– Temperature– Mood– Inhibits pain
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Excitatory Neurotransmitters
• Dopamine– Subconscious
movement– Fine motor skills– Emotional responses
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Excitatory Neurotransmitters
• Norepinepherine– Maintains arousal – Overall activity– Mood
• Acetylcholine– Vital for short term
memory
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Inhibitory Neurotransmitters
• Cholinergic– Stabilizers
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Inhibitory Neurotransmitters
• Gammaamniobutyricacid• GABA– #1 – h concentration in • brain
– Stop/slow firing of neurons
• Glycine– h concentration in • Spinal Cord
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Inhibitory Neurotransmitters
• Dopamine– Basal Ganglia– Dopamine &
Acetylcholine are opposites which work together to create homeostasis
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Course Objective #6
• Identify psychiatric disorders that appear to be related to the body’s inability to regulate the availability of neurotransmitters.
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h or i Neurotransmitters
• Imbalance disease or disorder
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Schizophrenia
• h dopamine
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Depression
• i Serotonin
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Alzheimer’s Disease
• i acetylcholine
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Generalized Anxiety Disorder
• Norepinephrine • Serotonin
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ADHD(Attention deficit hyperactivity disorder)
• Imbalance–Norepinephrine–Dopamine
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Drug Addictions
• Affects dopamine areas of the brain
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Alcohol
• Interacts with GABA receptors
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Course Objective #7
• Describe the ‘principle of opposition’ between the operation of the sympathetic and parasympathetic branches of the autonomic nervous system.
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The nervous system consists of:
• Divided system–Central Nervous System
(CNS)• Brain & Spinal Cord
–Peripheral Nervous System (PNS)• Nerves (peripheral &
Cranial)
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Nervous System
CNS PNS
Autonomic Nervous System
Somatic Nervous System
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Peripheral Nervous System
PNS comprised of Cranial and Spinal Nerves
Somatic Nervous SystemProcess: VoluntaryFunction: Respond to changes in external environmentEffector site: skeletal muscle
Autonomic Nervous systemProcess: InvoluntaryFunction: Respond to changes in the internal environmentEffector sites: Internal organs
Sympathetic NS Parasympathetic NS
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Autonomic Nervous System
Sympathetic Nervous System
• Chemical process:– Adrenergic
• Function– Energize
Parasympathetic Nervous System
• Chemical Process– Cholinergic
• Function– Stabilize
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Sympathetic NS Parasympathetic NS
Rate Heart rateDilates Vessels of
Skeletal muscles
0
Dilates Bronchi Constricts secretions Lung
secretions secretionsPeristalsis
Salivary secretions
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Sympathetic NS Parasympathetic NS
Closes Anal sphincter OpensRelaxes Bladder ContractsCloses Urinary
sphincter OpensDilate Pupil Constrict far vision Eye
accommodation
near vision
secretions Pancreas secretionsRelease glucose Liver 0 secretions Adrenal
Medulla0
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Principle of Opposition
Sympathetic Parasympathetic“Fight or Flight” “Rest & Digest”Energizes StabilizesAdrenergic Cholinergic(Adrenal gland) Epinephrine Norepinephrine
Acetylcholine
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Adrenergic vs. Cholinergic Agents
Adrenergic CholinergicSympathetic N.S. Parasympathetic N.S.Norepinephrine / Epinephrine
Acetylcholine
Adrenergic Agent Cholinergic AgentDrug that mimicsSympathetic stim.
Drug that mimicsParasymathetic stim.
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Course Objective #8
• Differentiate between an agonistic drug and an antagonistic drug.
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Agonist
• Bind with receptor • Enhances response
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Antagonist
• Binds with receptor • Blocks response
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Course objective #13
• Describe the variable responses seen depending on the fit of drugs to receptor sites.
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Drug Action
• “Target” cells
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Drug Action
• Rx fits / “binds” receptor site • Influences
reaction• Mimics natural
body chemicals
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• “BIND”– Similar shape–Closer the fit Stronger the effect
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Types of Antagonists
Competitive• “Push off” agonist• h dose • Block action of agonist
Non-competitive• Does not “push off an
agonist from receptor• h dose …